Capsaicin (hot pepper ingredient) for sinus pain and headaches

An ENT colleague recently referred to me a patient with very persistent sensation of pressure in her sinuses. She’d had sinus surgery which relieved pain in one of her sinuses, but the pressure sensation persisted. She did not experience much pain, but the pressure was present constantly and was very distracting and upsetting. First we tried intravenous magnesium because her blood test showed a mild deficiency. This did not help and I gave her several acupuncture treatments, which helped only a little and the effect did not last. When she mentioned that sneezing helped for a brief period, I though that intranasal hot pepper extract, capsaicin could help, and in fact it did.

There are several over-the-counter nasal sprays containing capsaicin, but she found that only Ausanil brand was helpful. Other brands include Sinol and SInus Buster. Ausanil is being advertised for both sinus and migraine headaches. There only small studies showing that capsaicin applied into the nostril can relieve migraines and even cluster headaches. A small Italian study showed that if capsaicin is applied into the nostril on the side of the headache it helped, but when applied on the opposite side, it did not.

This is not an easy treatment because it causes severe burning and some people tolerate it well, while other do not. It is certainly safe and inexpensive.